A Study of Mirvetuximab Soravtansine vs. Investigator's Choice (IC) of Chemotherapy in Platinum-Resistant, Advanced High-Grade Epithelial Ovarian, Primary Peritoneal, or Fallopian Tube Cancers With High Folate Receptor-Alpha (FRα) Expression

Phase 3

Completed

• Conditions: Epithelial Ovarian Cancer; Peritoneal Cancer; Fallopian Tube Cancer
• Interventions: Drug: Paclitaxel; Drug: Mirvetuximab Soravtansine; Drug: Topotecan; Drug: Pegylated liposomal doxorubicin

• Registration Number: NCT04209855
• Lead Sponsor: AbbVie

Brief Summary

This Phase 3 study is designed to compare the efficacy and safety of mirvetuximab soravtansine (MIRV) vs. IC chemotherapy in participants with platinum-resistant high-grade epithelial ovarian cancer, primary peritoneal, or fallopian tube cancer, whose tumors express a high-level of FRα. Participants will be, in the opinion of the Investigator, appropriate for single-agent therapy for their next line of therapy. The FRα positivity will be defined by the Ventana FOLR1 (FOLR1-2.1) CDx assay.

Detailed Description

Participants will be randomized to either MIRV or IC chemotherapy (paclitaxel, PEGylated liposomal doxorubicin, or topotecan).

Study Timeline

• Study First Submitted: 2019-12-17
• Study First Submitted QC: 2019-12-20
• Study First Posted: 2019-12-24
• Study Start: 2019-12-31
• Primary Completion: 2023-03-06
• Results First Submitted: 2024-07-08
• Results First Submitted QC: 2024-07-08
• Results First Posted: 2024-08-01
• Study Completion: 2024-08-22
• Status Verified: 2025-01
• Last Update Submitted: 2025-01-05
• Last Update Posted: 2025-01-07

Recruitment & Eligibility

• Status: COMPLETED
• Sex: Female
• Target Recruitment: 453

Inclusion Criteria

1. Female participants ≥ 18 years of age

2. Participants must have a confirmed diagnosis of high-grade serious epithelial ovarian cancer, primary peritoneal cancer, or fallopian tube cancer

3. Participants must have platinum-resistant disease:

   1. Participants who have only had 1 line of platinum based therapy must have received at least 4 cycles of platinum, must have had a response (CR or PR) and then progressed between >3 months and ≤ 6 months after the date of the last dose of platinum
   2. Participants who have received 2 or 3 lines of platinum therapy must have progressed on or within 6 months after the date of the last dose of platinum Note: Progression should be calculated from the date of the last administered dose of platinum therapy to the date of the radiographic imaging showing progression. Note: Participants who are platinum-refractory during front-line treatment are excluded

4. Participants must have progressed radiographically on or after their most recent line of therapy

5. Participants must be willing to provide an archival tumor tissue block or slides, or undergo procedure to obtain a new biopsy using a low risk, medically routine procedure for immunohistochemistry (IHC) confirmation of FRα positivity

6. Participant's tumor must be positive for FRα expression as defined by the Ventana FOLR1 (FOLR-2.1) CDx assay

7. Participants must have at least one lesion that meets the definition of measurable disease by Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1 (radiologically measured by the Investigator)

8. Participants must have received at least 1 but no more than 3 prior systemic lines of anticancer therapy, and for whom single-agent therapy is appropriate as the next line of treatment:

   1. Adjuvant ± neoadjuvant considered one line of therapy
   2. Maintenance therapy (for example, bevacizumab, poly (ADP-ribose) polymerase [PARP] inhibitors) will be considered as part of the preceding line of therapy (that is, not counted independently)
   3. Therapy changed due to toxicity in the absence of progression will be considered as part of the same line (that is, not counted independently)
   4. Hormonal therapy will be counted as a separate line of therapy unless it was given as maintenance

9. Participant must have an Eastern Cooperative Oncology Group Performance Status (ECOG PS) of 0 or 1

10. Time from prior therapy:

    1. Systemic antineoplastic therapy (5 half-lives or 4 weeks, whichever is shorter)
    2. Focal radiation completed at least 2 weeks prior to first dose of study drug

11. Participants must have stabilized or recovered (Grade 1 or baseline) from all prior therapy-related toxicities

12. Major surgery must be completed at least 4 weeks prior to first dose and have recovered or stabilized from the side effects of prior surgery

13. Participants must have adequate hematologic, liver and kidney functions defined as:

    1. Absolute neutrophil count (ANC) ≥ 1.5 x 10^9/liter (L) (1,500/microliter [μL]) without granulocyte colony-stimulating factor (G-CSF) in the prior 10 days or long-acting white blood cell (WBC) growth factors in the prior 20 days
    2. Platelet count ≥ 100 x 10^9/L (100,000/μL) without platelet transfusion in the prior 10 days
    3. Hemoglobin ≥ 9.0 g/dL without packed red blood cell (PRBC) transfusion in the prior 21 days
    4. Serum creatinine ≤ 1.5 x upper limit of normal (ULN)
    5. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 3.0 x ULN
    6. Serum bilirubin ≤ 1.5 x ULN (participants with documented diagnosis of Gilbert syndrome are eligible if total bilirubin < 3.0 x ULN
    7. Serum albumin ≥ 2 grams (g)/deciliter (dL)

14. Participants or their legally authorized representative must be willing and able to sign the informed consent form (ICF) and to adhere to the protocol requirements

15. Women of childbearing potential (WCBP) must agree to use highly effective contraceptive method(s) while on study drug and for at least 3 months after the last dose of MIRV or at least 6 months after the last dose of paclitaxel, pegylated liposomal doxorubicin, or topotecan

16. WCBP must have a negative pregnancy test within 4 days prior to the first dose of study drug

Exclusion Criteria

1. Participants with endometrioid, clear cell, mucinous, or sarcomatous histology, mixed tumors containing any of the above histologies, or low-grade or borderline ovarian tumor

2. Participants with primary platinum-refractory disease, defined as disease that did not respond to (CR or PR) or has progressed within 3 months of the last dose of first line platinum-containing chemotherapy

3. Participants with prior wide-field radiotherapy (RT) affecting at least 20% of the bone marrow

4. Participants with > Grade 1 peripheral neuropathy per Common Terminology Criteria for Adverse Events (CTCAE) v5.0

5. Participants with active or chronic corneal disorders, history of corneal transplantation, or active ocular conditions requiring ongoing treatment/monitoring such as uncontrolled glaucoma, wet age-related macular degeneration requiring intravitreal injections, active diabetic retinopathy with macular edema, macular degeneration, presence of papilledema, and /or monocular vision

6. Participants with serious concurrent illness or clinically relevant active infection, including, but not limited to the following:

   1. Active hepatitis B or C infection (whether or not on active antiviral therapy)
   2. Human immunodeficiency virus (HIV) infection
   3. Active cytomegalovirus infection
   4. Any other concurrent infectious disease requiring IV antibiotics within 2 weeks before starting study drug Note: Testing at screening is not required for the above infections unless clinically indicated

7. Participants with history of multiple sclerosis or other demyelinating disease and/or Lambert-Eaton syndrome (paraneoplastic syndrome)

8. Participants with clinically significant cardiac disease including, but not limited to, any one of the following:

   1. Myocardial infarction ≤ 6 months prior to first dose
   2. Unstable angina pectoris
   3. Uncontrolled congestive heart failure (New York Heart Association > class II)
   4. Uncontrolled ≥ Grade 3 hypertension (per CTCAE)
   5. Uncontrolled cardiac arrhythmias

9. Participants assigned to PLD stratum only: Left ventricular ejection fraction (LVEF) below the institutional limit of normal as measured by echocardiography (ECHO) or multigated acquisition (MUGA) scan

10. Participants with a history of hemorrhagic or ischemic stroke within six months prior to randomization

11. Participants with a history of cirrhotic liver disease (Child-Pugh Class B or C)

12. Participants with a previous clinical diagnosis of non-infectious interstitial lung disease (ILD), including noninfectious pneumonitis

13. Participants with required use of folate-containing supplements (for example, folate deficiency)

14. Participants with prior hypersensitivity to monoclonal antibodies

15. Women who are pregnant or lactating

16. Participants with prior treatment with MIRV or other FRα-targeting agents

17. Participants with untreated or symptomatic central nervous system (CNS) metastases

18. Participants with a history of other malignancy within 3 years prior to randomization. Note: does not include tumors with a negligible risk for metastasis or death (for example, adequately controlled basal-cell carcinoma or squamous-cell carcinoma of the skin, or carcinoma in situ of the cervix or breast

19. Prior known hypersensitivity reactions to study drugs and/or any of their excipients

20. People who are detained through a court or administrative decision, receiving psychiatric care against their will, adults who are the subject of a legal protection order (under tutorship/curatorship), people who are unable to express their consent, and people who are subject to a legal guardianship order

21. Simultaneous participation in another research study, in countries or localities where this is the health authority guidance

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Investigator's Choice (IC) Chemotherapy	Pegylated liposomal doxorubicin	Participants will receive a dose of IC chemotherapeutic agent calculated using body surface area (BSA). Paclitaxel administered at 80 milligrams/square meter (mg/m\^2) as a 1-hour IV infusion on Days 1, 8, 15, and 22 of a 4-week cycle; or topotecan administered at 4 mg/m\^2 over 30 minutes on Days 1, 8, and 15 of a 4-week cycle. Alternatively, topotecan could be administered at 1.25 mg/m\^2 over 30 minutes on Days 1 to 5 of a 3-week cycle; or pegylated liposomal doxorubicin administered at 40 mg/m\^2 as a 1 mg/minute IV infusion on Day 1 of a 4-week cycle. After Cycle 1, if tolerated, pegylated liposomal doxorubicin could be administered as a 1-hour infusion.
Investigator's Choice (IC) Chemotherapy	Paclitaxel	Participants will receive a dose of IC chemotherapeutic agent calculated using body surface area (BSA). Paclitaxel administered at 80 milligrams/square meter (mg/m\^2) as a 1-hour IV infusion on Days 1, 8, 15, and 22 of a 4-week cycle; or topotecan administered at 4 mg/m\^2 over 30 minutes on Days 1, 8, and 15 of a 4-week cycle. Alternatively, topotecan could be administered at 1.25 mg/m\^2 over 30 minutes on Days 1 to 5 of a 3-week cycle; or pegylated liposomal doxorubicin administered at 40 mg/m\^2 as a 1 mg/minute IV infusion on Day 1 of a 4-week cycle. After Cycle 1, if tolerated, pegylated liposomal doxorubicin could be administered as a 1-hour infusion.
Investigator's Choice (IC) Chemotherapy	Topotecan	Participants will receive a dose of IC chemotherapeutic agent calculated using body surface area (BSA). Paclitaxel administered at 80 milligrams/square meter (mg/m\^2) as a 1-hour IV infusion on Days 1, 8, 15, and 22 of a 4-week cycle; or topotecan administered at 4 mg/m\^2 over 30 minutes on Days 1, 8, and 15 of a 4-week cycle. Alternatively, topotecan could be administered at 1.25 mg/m\^2 over 30 minutes on Days 1 to 5 of a 3-week cycle; or pegylated liposomal doxorubicin administered at 40 mg/m\^2 as a 1 mg/minute IV infusion on Day 1 of a 4-week cycle. After Cycle 1, if tolerated, pegylated liposomal doxorubicin could be administered as a 1-hour infusion.
Mirvetuximab Soravtansine	Mirvetuximab Soravtansine	Participants will receive single-agent mirvetuximab soravtansine (MIRV) at 6 milligrams (mg)/kilogram (kg) adjusted ideal body weight (AIBW) administered intravenously (IV) on Day 1 of every 3-week cycle (Q3W).

Primary Outcome Measures

Name	Time	Method
Progression-free Survival (PFS) as Assessed by Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1	From randomization until PD or death, whichever occurred first (up to 28 months)	PFS was defined as the time from randomization until progressive disease (PD) or death whichever occurred first. PD: At least a 20% increase in the sum of the longest diameters (SoD) of target lesion, taken as reference the smallest (nadir) SoD since and including baseline. In addition to the relative increase of 20%, the SoD must also demonstrate an absolute increase of at least 5 millimeters (mm). Unequivocal progression of non-target lesions and appearance of new lesions. Unequivocal progression should not normally trump target lesion status. It must be representative of overall disease status change, not a single lesion increase.

Secondary Outcome Measures

Name	Time	Method
Number of Participants With Treatment-emergent Adverse Events (TEAEs)	Up to 28 months	An adverse event (AE) is defined as any untoward medical occurrence that develops or worsens in severity during the conduct of a clinical study and does not necessarily have a causal relationship to study drug. TEAEs are defined as AEs with an onset date on or after the first dose of Study drug, and within 30 days of the last dose of study drug or prior to the start of a new anticancer treatment, whichever occurrs first.
Overall Survival Assessed by the Investigator Using RECIST v1.1	Up to 30 months	Overall survival is defined as the time from the date of first dose until the date of death from any cause, estimated using the Kaplan-Meier method.
Percentage of Participants With CA-125 Confirmed Clinical Response Per Gynecologic Cancer Intergroup (GCIG) Criteria	Up to 28 months	The GCIG CA-125 response is defined as at least 50% reduction in CA-125 levels from baseline. The response must have been confirmed and maintained for at least 28 days.
Time to Second Progression-Free Survival (PFS 2)	Up to 28 months	PFS 2 is defined as the time from date of randomization until second disease progression or death whichever occurs first.
Objective Response Rate (ORR), as Assessed by the Investigator Using RECIST v1.1	Up to 28 months	ORR is defined as percentage of participants with a confirmed best overall response (BOR) of complete response (CR) or partial response (PR). CR: Disappearance of all target or non-target lesions. All pathological or non-pathological lymph nodes (whether target or non-target) must have reduction in short axis to \<10 mm. PR: At least 30% decrease in the sum of the longest diameters (SoD) of target lesions, taking as reference the baseline SoD.
Duration of Response (DOR) as Assessed by the Investigator Using RECIST v1.1	Up to 28 months	DOR is defined as the time from the date of the first response (CR or PR), until the date of PD or death from any cause, whichever occurrs first. DOR for participants who has not progressed or died at the time of analysis are censored at the date of their last tumor assessment. PD: At least a 20% increase in the SoD of target lesion, taken as reference the smallest (nadir) SoD since and including baseline. In addition to the relative increase of 20%, the SoD must also demonstrate an absolute increase of at least 5 mm. Unequivocal progression of non-target lesions. Unequivocal progression should not normally trump target lesion status. It must be representative of overall disease status change, not a single lesion increase. DOR is estimated using the Kaplan-Meier method.
Number of Participants Achieving at Least 15 Point Absolute Improvement at Week 8 or 9 in the Abdominal/GI Scale of European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire - Ovarian Cancer Module 28 (QLQ-OV28)	Baseline and Week 8 or 9	EORTC-QLQ-OV28 includes 3 functional scales (body image, sexuality, attitude to disease/treatment) and 5 symptom scales/items (abdominal/gastrointestinal \[GI\] symptoms, peripheral neuropathy, hormonal/menopausal symptoms, other chemotherapy side-effects, and hair loss). Functional scales score (body Image and attitude to disease/treatment) is calculated by averaging scores of all scale items and transforming average scores linearly (1 minus \[average score minus 1\] divided by 3\*100). Functional scales score (sexuality) is calculated by averaging scores of all scale items and transforming average scores linearly (\[average score minus 1\] divided by 3\*100). All of the functional scales range in score from 0 to 100. Higher score represents a higher ("better") level of functioning. The number of participants achieving at least 15 point absolute improvement at Week 8 or Week 9 in the abdominal/GI scale of the EORTC QLQ-OV28.

Trial Locations

Locations (213)

Illinois Cancer Specialists; 🇺🇸 Arlington Heights, Illinois, United States

Cleveland Clinic; 🇺🇸 Cleveland, Ohio, United States

Fudan University Shanghai Cancer Center; 🇨🇳 Shanghai, China

USOR: Texas Oncology - San Antonio; 🇺🇸 San Antonio, Texas, United States

USOR: Arizona Oncology Associates, PC - HOPE; 🇺🇸 Tucson, Arizona, United States

UCLA - JCCC Dept of OBGYN - Women's Health Clinical Research Unit; 🇺🇸 Los Angeles, California, United States

Hoag Cancer Center; 🇺🇸 Newport Beach, California, United States

Olive View - UCLA Medical Center; 🇺🇸 Sylmar, California, United States

Kaiser Permanente Oncology Clinical Trials; 🇺🇸 Vallejo, California, United States

USOR: Rocky Mountain Cancer Centers; 🇺🇸 Lakewood, Colorado, United States

Women's Care Florida / Women's Cancer Associates; 🇺🇸 Saint Petersburg, Florida, United States

Florida Cancer Specialist South Division; 🇺🇸 Fort Myers, Florida, United States

Mayo Clinic Jacksonville; 🇺🇸 Jacksonville, Florida, United States

Florida Cancer Specialists; 🇺🇸 Tallahassee, Florida, United States

Florida Cancer Specialist North Division; 🇺🇸 Saint Petersburg, Florida, United States

Sarasota Memorial Hospital; 🇺🇸 Sarasota, Florida, United States

Florida Cancer Specialist East Division; 🇺🇸 West Palm Beach, Florida, United States

Memorial University Medical Center; 🇺🇸 Savannah, Georgia, United States

University of Chicago; 🇺🇸 Chicago, Illinois, United States

Dr. Sudarshan K. Sharma, Ltd.; 🇺🇸 Hinsdale, Illinois, United States

Community Health Network; 🇺🇸 Indianapolis, Indiana, United States

St. Elizabeth Healthcare; 🇺🇸 Edgewood, Kentucky, United States

Holy Cross Hospital; 🇺🇸 Silver Spring, Maryland, United States

USOR: Maryland Oncology Hematology, P.A.; 🇺🇸 Silver Spring, Maryland, United States

Sletten Cancer Institute; 🇺🇸 Great Falls, Montana, United States

USOR: Minnesota Oncology Hematology, PA; 🇺🇸 Woodbury, Minnesota, United States

Center of Hope; 🇺🇸 Reno, Nevada, United States

Columbia University Medical Center; 🇺🇸 New York, New York, United States

USOR: OHC - Oncology_Hematology Care Clinical Trials, Inc.; 🇺🇸 Cincinnati, Ohio, United States

FirstHealth of the Carolinas Outpatient Cancer Center; 🇺🇸 Pinehurst, North Carolina, United States

Columbus NCORP; 🇺🇸 Columbus, Ohio, United States

Zangmeister Cancer Center; 🇺🇸 Columbus, Ohio, United States

Oncology_Hematology Care Clinical Trials, LLC; 🇺🇸 Fairfield, Ohio, United States

The Ohio State University Wexner Medical Center; 🇺🇸 Hilliard, Ohio, United States

Oklahoma Cancer Specialists and Research Institute; 🇺🇸 Tulsa, Oklahoma, United States

USOR: Willamette Valley Cancer Institute and Research Center; 🇺🇸 Eugene, Oregon, United States

Fox Chase Cancer Center; 🇺🇸 Philadelphia, Pennsylvania, United States

University of Pennsylvania; 🇺🇸 Philadelphia, Pennsylvania, United States

Magee-Women's Hospital-UPMC; 🇺🇸 Pittsburgh, Pennsylvania, United States

West Penn Hospital; 🇺🇸 Pittsburgh, Pennsylvania, United States

Women & Infants Hospital of Rhode Island; 🇺🇸 Providence, Rhode Island, United States

University of Texas, Memorial Hermann; 🇺🇸 Houston, Texas, United States

USOR: Texas Oncology - Fort Worth Cancer Center; 🇺🇸 Fort Worth, Texas, United States

USOR: Texas Oncology - McAllen South Second; 🇺🇸 McAllen, Texas, United States

USOR: Texas Oncology, P.A.; 🇺🇸 Webster, Texas, United States

USOR: Texas Oncology - The Woodlands, Gynecologic Oncology; 🇺🇸 The Woodlands, Texas, United States

USOR: Texas Oncology - Tyler; 🇺🇸 Tyler, Texas, United States

University of Virginia Health System; 🇺🇸 Charlottesville, Virginia, United States

USOR: Virginia Cancer Specialists, PC; 🇺🇸 Gainesville, Virginia, United States

Newcastle Private Hospital; 🇦🇺 New Lambton Heights, New South Wales, Australia

West Virginia University- MBRCC; 🇺🇸 Morgantown, West Virginia, United States

Kadlec Clinic Hematology & Oncology; 🇺🇸 Kennewick, Washington, United States

Prince of Wales Hospital; 🇦🇺 Randwick, New South Wales, Australia

Burnside War Memorial Hospital - The Brian Fricker Oncology Centre; 🇦🇺 Toorak Gardens, Australia

Monash Health; 🇦🇺 Clayton, Victoria, Australia

Oncology Clinics Victoria (OCV) - Cabrini Malvern Hospital Location; 🇦🇺 Malvern, Victoria, Australia

Royal North Shore Hospital; 🇦🇺 Saint Leonards, Australia

OLV Ziekenhuis; 🇧🇪 Aalst, Belgium

AZ Klina; 🇧🇪 Brasschaat, Belgium

UZ Leuven; 🇧🇪 Leuven, Belgium

Complex Oncology Center; 🇧🇬 Burgas, Bulgaria

AZ St-Lucas; 🇧🇪 Gent, Belgium

Acibadem City Clinic Tokuda Hospital; 🇧🇬 Sofia, Bulgaria

UMHAT "Sv. Ivan Rilski", EAD, Sofia; 🇧🇬 Sofia, Bulgaria

UMHAT Georgi Stranski; 🇧🇬 Pleven, Bulgaria

The Ottawa Hospital General Campus; 🇨🇦 Ottawa, Ontario, Canada

Princess Margaret Cancer Centre - University Health Network; 🇨🇦 Toronto, Ontario, Canada

McGill University Health Centre; 🇨🇦 Montreal, Quebec, Canada

Centre Hospitalier de L'Universite de Montreal; 🇨🇦 Montréal, Quebec, Canada

Anhui Provincial Cancer Hospital; 🇨🇳 Hefei, Anhui, China

Hubei Cancer Hospital; 🇨🇳 Wuhan, Hubei, China

Zhongnan Hospital of Wuhan University; 🇨🇳 Wuhan, Hubei, China

Zhongshan Hospital Xiamen University; 🇨🇳 Xiamen, Fujian, China

Wuhan Union Hospital of China; 🇨🇳 Wuhan, Hubei, China

Sun Yat-sen University, Cancer Center; 🇨🇳 Guangzhou, Guangdong, China

The First Affiliated Hospital of Soochow University; 🇨🇳 Suzhou, Jiangsu, China

The First Hospital of Jilin University; 🇨🇳 Changchun, Jilin, China

Liaoning Cancer Hospital; 🇨🇳 Shenyang, Liaoning, China

Peking University First Hospital; 🇨🇳 Beijing, China

The First Affiliated Hospital of Xi'an Jiaotong University; 🇨🇳 Xi'an, Shanxi, China

Beijing Cancer Hospital; 🇨🇳 Beijing, China

Tianjin Medical University Cancer Institute & Hospital; 🇨🇳 Tianjin, China

Fakultní nemocnice Ostrava; 🇨🇿 Ostrava, Czechia

Všeobecná fakultní nemocnice v Praze; 🇨🇿 Praha 2, Czechia

Centre Oscar Lambret; 🇫🇷 Lille, Cedex B.P 307, France

Institut Claudius Regaud; 🇫🇷 Toulouse, Cedex 9, France

Institut de cancérologie de l'ouest, site Angers; 🇫🇷 Angers, Cedex, France

Institut Bergonie; 🇫🇷 Bordeaux Cedex, France

Centre Leon Berard; 🇫🇷 Lyon Cedex, France

Institut Paoli Calmettes; 🇫🇷 Marseille, France

Cochin Hospital; 🇫🇷 Paris, France

Groupe Hospitalier Diaconesses Croix Saint-Simon; 🇫🇷 Paris, France

Centre Hospitalier Lyon Sud; 🇫🇷 Pierre-Bénite, France

Centre Armoricain de radiothérapie, imagerie médicale et oncologie, CARIO; 🇫🇷 Plerin, France

Institut Curie; 🇫🇷 Saint Cloud, France

Ulm University Hospital Klinik für Frauenheilkunde und Geburtshilfe; 🇩🇪 Ulm, Baden-Württemberg, Germany

Institut de cancérologie de Lorraine; 🇫🇷 Vandoeuvre les Nancy_ Cedex, France

ICO Centre René Gauducheau; 🇫🇷 St. Herblain CEDEX, France

UMG Göttingen Frauenklinik; 🇩🇪 Göttingen, Niedersachsen, Germany

Gustave Roussy; 🇫🇷 Villejuif Cedex, France

Universitätsklinikum Bonn; 🇩🇪 Bonn, Germany

Städtisches Klinikum Dessau, Zentrum für Klinische Studien; 🇩🇪 Dessau, Germany

Klinikum Dortmund gGmbH / Frauenklinik; 🇩🇪 Dortmund, Germany

INT Pascale; 🇮🇹 Naples, Italy

UKGM Standort Giessen; 🇩🇪 Giessen, Germany

Mammazentrum Hamburg am Krankenhaus Jerusalem; 🇩🇪 Hamburg, Germany

University Hospital Freiburg; 🇩🇪 Freiburg, Germany

Meir Medical Center; 🇮🇱 Kfar Saba, Israel

Sheba Medical Center; 🇮🇱 Ramat Gan, Israel

Ziv Medical Center; 🇮🇱 Safed, Israel

Kaplan Medical Center; 🇮🇱 Rehovot, Israel

Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia; 🇮🇹 Brescia, Italy

ASST Lecco- Ospedale A.Manzoni; 🇮🇹 Lecco, Italy

National Cancer Center - Center for Uterine Cancer; 🇰🇷 Gyeonggi-do, Korea, Republic of

Samsung Medical Center; 🇰🇷 Seoul, Korea, Republic of

Seoul National University Hospital; 🇰🇷 Seoul, Korea, Republic of

Seoul National University Bundang Hospital; 🇰🇷 Seongnam-si, Korea, Republic of

Severance Hospital; 🇰🇷 Seoul, Korea, Republic of

University of Ulsan College of Medicine - Asan Medical Center; 🇰🇷 Seoul, Korea, Republic of

Radboud University Medical Center; 🇳🇱 Nijmegen, Netherlands

Maastricht UMC; 🇳🇱 Maastricht, Netherlands

Erasmus Medical Center; 🇳🇱 Rotterdam, Netherlands

Medical University of Gdansk; 🇵🇱 Gdańsk, Poland

Wojewódzki Szpital Specjalistyczny, Oddzial Kliniczny Ginekologii Onkologiczne; 🇵🇱 Olsztyn, Poland

Szpital Kliniczny im. Ks. Anny Mazowieckiej; 🇵🇱 Warszawa, Poland

Wielkopolskie Centrum Onkologii; 🇵🇱 Poznań, Poland

LLC "VitaMed"; 🇷🇺 Moscow, Russian Federation

Fundação Champalimaud; 🇵🇹 Lisbon, Portugal

Hospital da Luz, S.A; 🇵🇹 Lisbon, Portugal

Centro Hospitalar de Lisboa Norte, E.P.E. - Hospital de Santa Maria; 🇵🇹 Lisbon, Portugal

Hospital Beatriz Angelo; 🇵🇹 Loures, Portugal

Leningrad regional oncology dispensa; 🇷🇺 St-Petersburg, Russian Federation

Oncology and Radiology Institute Serbia; 🇷🇸 Belgrade, Serbia

Clinical Center Kragujevac; 🇷🇸 Kragujevac, Serbia

Oncology Institute Vojvodina, Surgical Oncology Clinic; 🇷🇸 Sremska Kamenica, Serbia

Hospital de San Chinarro-Clara Campal; 🇪🇸 Madrid, Spain

Hospital Universitario Infanta Sofía; 🇪🇸 San Sebastián de los Reyes, Madrid, Spain

H. U. de Jaén; 🇪🇸 Jaén, Andalucia, Spain

Hospital Clínico de Santiago; 🇪🇸 Santiago de Compostela, A Coruña, Spain

Institut Català d'Oncologia; 🇪🇸 Badalona, Spain

H. San Pedro de Alcántara; 🇪🇸 Caceres, Spain

Hospital Provincial de Castellon; 🇪🇸 Castelló, Spain

Hospital Clínico Universitario Virgen de la Arrixaca; 🇪🇸 Murcia, Spain

Parc Taulí; 🇪🇸 Sabadell, Spain

Virgen del Rocío; 🇪🇸 Sevilla, Spain

Hospital de la Fe; 🇪🇸 Valencia, Spain

HCU Lozano Blesa; 🇪🇸 Zaragoza, Spain

Far Eastern Memorial Hospital; 🇨🇳 New Taipei City, Taiwan

Mackay Memorial Hospital - Taipei Branch; 🇨🇳 Taipei City, Taiwan

Taipei Veterans General Hospital; 🇨🇳 Taipei City, Taiwan

Grigoriev Institute for Medical Radiology NAMS of Ukraine; 🇺🇦 Kharkiv, Kharkiv Region, Ukraine

Chernihiv Medical Center of Modern Oncology of Chernihiv Regional Council; 🇺🇦 Chernihiv, Chernihiv Region, Ukraine

Communal non-profit enterprise "Khmelnytskyi Regional Antitumor Center" of Khmelnytskoyi Regional Council; 🇺🇦 Khmelnytskyi, Khmelnytskyi Region, Ukraine

Communal non-profit enterprise "Cherkasy Regional Oncology Dispensary of Cherkasy oblast council"; 🇺🇦 Cherkasy, Ukraine

Royal Devon and Exeter Hospital (Wonford); 🇬🇧 Exeter, Devon, United Kingdom

University Hospitals Coventry and Warwickshire; 🇬🇧 Coventry, United Kingdom

Beatson West of Scotland Cancer Centre; 🇬🇧 Glasgow, United Kingdom

St Bartholomew's Hospital-Barts Health NHS Trust; 🇬🇧 London, United Kingdom

The Christie NHS Foundation Trust; 🇬🇧 Manchester, United Kingdom

University College London Hospital; 🇬🇧 London, United Kingdom

The Royal Marsden NHS Foundation Trust; 🇬🇧 London, United Kingdom

University of Kansas Cancer Center; 🇺🇸 Westwood, Kansas, United States

The Valley Hospital, Inc; 🇺🇸 Ridgewood, New Jersey, United States

Alaska Women's Cancer Care; 🇺🇸 Anchorage, Alaska, United States

University of Massachusetts; 🇺🇸 Worcester, Massachusetts, United States

Cross Cancer Institute; 🇨🇦 Edmonton, Alberta, Canada

Universitair Ziekenhuis Antwerpen (UZA) - Borstkliniek; 🇧🇪 Edegem, Belgium

Hadassah Ein Kerem Medical center; 🇮🇱 Jerusalem, Israel

State Autonomous Healthcare Institution Republican Clinical Oncological Dispensary of the MoH of Republic Bashkortostan; 🇷🇺 Ufa, Russian Federation

WK Physicians Network/Gynecologic Oncology Associates; 🇺🇸 Shreveport, Louisiana, United States

Tom Baker Cancer Centre; 🇨🇦 Calgary, Alberta, Canada

Tufts Medical Center; 🇺🇸 Boston, Massachusetts, United States

BIH of Omsk Region "Clinical Oncology Dispensary"; 🇷🇺 Omsk, Omsk Oblast, Russian Federation

Centre Hospitalier Universitaire de Sherbrooke; 🇨🇦 Sherbrooke, Quebec, Canada

Holy Name Medical Center; 🇺🇸 Teaneck, New Jersey, United States

Baystate Medical Center; 🇺🇸 Springfield, Massachusetts, United States

Samodzielny publiczny szpital kliniczny nr 1; 🇵🇱 Lublin, Poland

Universitätsklinikum Carl Gustav Carus Dresden; 🇩🇪 Dresden, Saxony, Germany

Prykarpatskyi Clinical Oncology Center of Ivano-Frankivsk Regional Council; 🇺🇦 Ivano-Frankivsk, Ukraine

Peterborough City Hospital; 🇬🇧 Peterborough, Cambridgeshire, United Kingdom

IOV Istituto Oncologico; 🇮🇹 Padova, PD, Italy

Ospedale Mauriziano Umberto I; 🇮🇹 Torino, Italy

Istituto Oncologico Candiolo; 🇮🇹 Torino, Italy

IRCCS - Istituto Europeo di Oncologia (The European Institute of Oncology) (IEO); 🇮🇹 Milan, Italy

Centro Operativo Studi Clinici S.C.Oncologia Medica; 🇮🇹 Perugia, Italy

Oncologia Azienda Osc-IRCCS Reggio Emilia; 🇮🇹 Reggio Emilia, Italy

Fondazione Policlinico Universitario Agostino Gemelli IRCCS; 🇮🇹 Rome, Italy

Azienda Ospedaliera Città Della Salute E Della Scienza Di Torino; 🇮🇹 Torino, Italy

Arizona Oncology Associates, PC - HAL - USOR; 🇺🇸 Phoenix, Arizona, United States

Mayo Clinic; 🇺🇸 Phoenix, Arizona, United States

University of California San Francisco; 🇺🇸 San Francisco, California, United States

Karmanos Cancer Institute; 🇺🇸 Detroit, Michigan, United States

Stephenson Cancer Center; 🇺🇸 Oklahoma City, Oklahoma, United States

Tennessee Oncology / Sarah Cannon Research Institute; 🇺🇸 Nashville, Tennessee, United States

University of Alabama at Birmingham (UAB) GYN Oncology; 🇺🇸 Birmingham, Alabama, United States

Wolfson Medical Center; 🇮🇱 Holon, Israel

KNTB a.s. Zlín; 🇨🇿 Zlín, Czechia

Amsterdam UMC; 🇳🇱 Amsterdam, Netherlands

CHRU Besançon; 🇫🇷 Besançon Cedex, France

Mayo Clinic Rochester; 🇺🇸 Rochester, Minnesota, United States

USOR: Northwest Cancer Specialists, P.C.; 🇺🇸 Portland, Oregon, United States

Legacy Gynecologic Oncology; 🇺🇸 Portland, Oregon, United States

Sunnybrook Health Sciences Center; 🇨🇦 Toronto, Ontario, Canada

MetroHealth Medical Center; 🇺🇸 Cleveland, Ohio, United States

University of Arizona Cancer Center; 🇺🇸 Tucson, Arizona, United States

Yale University School of Medicine; 🇺🇸 New Haven, Connecticut, United States

Norton Cancer Institute; 🇺🇸 Louisville, Kentucky, United States

Ochnser Medical Center Jefferson; 🇺🇸 New Orleans, Louisiana, United States

St. Joseph Mercy Hospital; 🇺🇸 Ann Arbor, Michigan, United States

HCA Midwest Kansas City/ Sarah Cannon; 🇺🇸 Kansas City, Missouri, United States

USOR: Texas Oncology-South Austin; 🇺🇸 Austin, Texas, United States

Hawaii Pacific Health - Kapiolani Medical Center for Women and Children; 🇺🇸 Honolulu, Hawaii, United States

Fujian Cancer Hospital; 🇨🇳 Fuzhou, Fujian, China